scholarly journals Trends of caesarean section deliveries in Pakistan: secondary data analysis from Demographic and Health Surveys, 1990–2018

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aaisha Amjad ◽  
Abeeha Imran ◽  
Nabeeha Shahram ◽  
Rubeena Zakar ◽  
Ahmed Usman ◽  
...  

Abstract Background Pakistan is among those countries where the number of caesarean section births has increased unusually in the past two decades. Therefore, the aim of the present study is to analyse the trend of caesarean section deliveries among child-bearing women (aged 15–49 years) in Pakistan and to identify maternal socio-demographic factors and pregnancy-related variables associated with the change in caesarean deliveries from 1990 to 2018. Methods Secondary data from Pakistan Demographic and Health Surveys (1990–2018) were analysed. The analysis of data was confined to child-bearing mothers. Sample sizes were 4029, 5721, 7461 and 8287 for the time periods of 1990–91, 2006–07, 2012–13 and 2017–18, respectively. Socio-demographic information of the mothers and pregnancy-related variables were taken as independent variables for the present study. The association between independent variables and caesarean deliveries was measured in terms of unadjusted odds ratios (OR) and adjusted OR (AOR). Results The percentages of the mothers who had at least one delivery during the 5 years prior to each survey who had caesarean deliveries increased continuously from 3.2% in 1990–91 to 19.6% in 2017–18. Results indicate that mothers over 24 years of age, located in Punjab, from the richest socio-economic class and living in urban areas were more likely to have delivered by caesarean section. Mothers with a first child in birth order and who had five and more children, as well as mothers who had more antenatal care visits and delivered babies in private hospitals showed a higher probability of caesarean section births. Conclusions The findings of the present study confirm the gradual upsurge in the percentage of mothers delivering by caesarean section during the past two decades in Pakistan. Against this backdrop, some measures need to be taken by health departments to regulate the number of caesarean deliveries. Awareness among women about pregnancy complications and elaborated details by gynaecologists about the medically indicated reasons for caesarean delivery are a few important steps in Pakistan that can help in reducing caesarean deliveries which are not medically indicated.

2020 ◽  
Author(s):  
Aaisha Amjad ◽  
Abeeha Imran ◽  
Nabeeha Shahram ◽  
Rubeena Zakar ◽  
Ahmed Usman ◽  
...  

Abstract Background: Pakistan is among those countries where the number of caesarean section births has increased unusually in the past two decades. Therefore, the aim of the present study is to analyse the trend of caesarean section deliveries among child-bearing women (aged 15–49 years) in Pakistan and to identify maternal socio-demographic factors and pregnancy-related variables associated with the change in caesarean deliveries from 1990 to 2018.Methods: Secondary data from Pakistan Demographic and Health Surveys (1990–2018) were analysed. The analysis of data was confined to child-bearing mothers. Sample sizes were 4,029, 5,721, 7,461 and 8,287 for the time periods of 1990–91, 2006–07, 2012–13 and 2017–18, respectively. Socio-demographic information of the mothers and pregnancy-related variables were taken as independent variables for the present study. The association between independent variables and caesarean deliveries was measured in terms of unadjusted odds ratios (OR) and adjusted OR (AOR).Results: The percentages of the mothers who had at least one delivery during the five years prior to each survey who had caesarean deliveries increased continuously from 3.2 % in 1990–91 to 19.6 % in 2017–18. Results indicate that mothers over 24 years of age, located in Punjab, from the richest socio-economic class and living in urban areas were more likely to have delivered by caesarean section. Mothers with a first child in birth order and who had five and more children, as well as mothers who had more antenatal care visits and delivered babies in private hospitals showed a higher probability of caesarean section births.Conclusions: The findings of the present study confirm the gradual upsurge in the percentage of mothers delivering by caesarean section during the past two decades in Pakistan. Against this backdrop, some measures need to be taken by health departments to regulate the number of caesarean deliveries. Awareness among women about pregnancy complications and elaborated details by gynaecologists about the medically indicated reasons for caesarean delivery are a few important steps in Pakistan that can help in reducing caesarean deliveries which are not medically indicated.


2020 ◽  
Author(s):  
Aaisha Amjad ◽  
Abeeha Imran ◽  
Nabeeha Shahram ◽  
Rubeena Zakar ◽  
Ahmad Usman ◽  
...  

Abstract Background Pakistan is amongst those countries where the number of caesarean section births has unusually increased in the past two decades. Therefore, the aim of the present study is to analyse the trend of caesarean section deliveries among child-bearing women (aged 15–49 years) in Pakistan and to identify maternal socio-demographic factors and pregnancy related variables associated with the change in caesarean deliveries from 1990 to 2018.Methods Secondary data from Pakistan Demographic and Health Surveys (1990–2018) were analysed. The analysis of data was confined to the child-bearing mothers. Sample sizes were 4,029, 5,721, 7,461 and 8,287 for the time period of 1990–91, 2006–07, 2012–13, and 2017–18, respectively. For the present study, socio-demographic information of the mothers and pregnancy related variables were taken as independent variables. The association between independent variables and caesarean deliveries was measured in terms of unadjusted odds ratios (OR) and adjusted odds ratios (AOR).Results Out of the mothers who had at least one delivery during the five years prior to each survey, the percentages of the mothers who had caesarean deliveries increased continuously from 3.2% in 1990–91 to 19.6% in 2017–18. Results indicate that mothers above 24 years of age, located in Punjab, from the richest socio-economic class, and living in urban areas were more likely to have delivered by caesarean section. Mothers with first child in birth order and who had five and above children, as well as mothers who had more antenatal care visits and delivered babies in private hospitals showed a higher probability for caesarean section births.Conclusions The findings of the present study confirm the gradual upsurge in the percentage of mothers delivering through caesarean section during the past two decades in Pakistan. In this backdrop, some measures need to be taken by health departments to regulate the number of caesarean deliveries. Awareness among women about pregnancy complications and elaborated details by gynaecologists about the medically indicated reasons of caesarean delivery are a few important steps that can help in reducing not medically indicated caesarean deliveries in Pakistan.


Author(s):  
Wenjun Zhu ◽  
Si Zhu ◽  
Bruno F. Sunguya ◽  
Jiayan Huang

Our study aims to examine the disparity of under-5 child stunting prevalence between urban and rural areas of Tanzania in the past three decades, and to explore factors affecting the rural–urban disparity. Secondary analyses of Tanzania Demographic and Health Surveys (TDHS) data drawn from 1991–1992, 1996, 1999, 2004–2005, 2009–2010, and 2015–2016 surveys were conducted. Under-5 child stunting prevalence was calculated separately for rural and urban children and its decline trends were examined by chi-square tests. Descriptive analyses were used to present the individual-level, household-level, and societal-level characteristics of children, while multivariable logistic regression analyses were performed to examine determinants of stunting in rural and urban areas, respectively. Additive interaction effects were estimated between residence and other covariates. The results showed that total stunting prevalence was declining in Tanzania, but urban–rural disparity has widened since the decline was slower in the rural area. No interaction effect existed between residence and other determinants, and the urban–rural disparity was mainly caused by the discrepancy of the individual-level and household-level factors between rural and urban households. As various types of determinants exist, multisector nutritional intervention strategies are required to address the child stunting problem. Meanwhile, the intervention should focus on targeting vulnerable children, rather than implementing different policies in rural and urban areas.


2014 ◽  
Vol 17 (11) ◽  
pp. 2407-2418 ◽  
Author(s):  
Helga Bjørnøy Urke ◽  
Maurice B Mittelmark ◽  
Martín Valdivia

AbstractObjectiveTo examine trends in stunting and overweight in Peruvian children, using 2006 WHO Multicentre Growth Reference Study criteria.DesignTrend analyses using nationally representative cross-sectional surveys from Demographic and Health Surveys (1991–2011). We performed logistic regression analyses of stunting and overweight trends in sociodemographic groups (sex, age, urban–rural residence, region, maternal education and household wealth), adjusted for sampling design effects (strata, clusters and sampling weights).SettingPeru.SubjectsChildren aged 0–59 months surveyed in 1991–92 (n 7999), 1996 (n 14 877), 2000 (n 11 754), 2007–08 (n 8232) and 2011 (n 8186).ResultsChild stunting declined (F(1, 5149) = 174·8, P ≤ 0·00) and child overweight was stable in the period 1991–2011 (F(1, 5147) = 0·4, P ≤ 0·54). Over the study period, levels of stunting were highest in rural compared with urban areas, the Andean and Amazon regions compared with the Coast, among children of low-educated mothers and among children living in households in the poorest wealth quintile. The trend in overweight rose among males in coastal areas (F(1, 2250) = 4·779, P ≤ 0·029) and among males in the richest wealth quintile (F(1, 1730) = 5·458, P ≤ 0·020).ConclusionsThe 2011 levels of stunting and overweight were eight times and three and a half times higher, respectively, than the expected levels from the 2006 WHO growth standards. The trend over the study period in stunting declined in most sociodemographic subgroups. The trend in overweight was stable in most sociodemographic subgroups.


2018 ◽  
Vol 21 (16) ◽  
pp. 3048-3057 ◽  
Author(s):  
Chloe M Harvey ◽  
Marie-Louise Newell ◽  
Sabu S Padmadas

AbstractObjectiveTo investigate the socio-economic differentials underlying minimum dietary diversity (MDD) among children aged 6–23 months in three economically diverse South-East Asian countries.DesignThe outcome variable MDD was defined as the proportion of children aged 6–23 months who received foods from four of the seven recommended food groups within the 24 h prior to interview. The association between socio-economic factors and MDD, adjusting for relevant characteristics, was examined using logistic regression.SettingWe used cross-sectional population data from recent Demographic and Health Surveys from Cambodia (2014), Myanmar (2015–16) and Indonesia (2012).SubjectsTotal of 8364 children aged 6–23 months.ResultsApproximately half of all children met the MDD, varying from 47·7 % in Cambodia (n1023) to 58·2 % in Indonesia (n2907) and 24·6 % in Myanmar (n301). The likelihood (adjusted OR; 95 % CI) of meeting MDD increased for children in the richest households (Cambodia: 2·4; 1·7, 3·4; Myanmar: 1·8; 1·1, 3·0; Indonesia: 2·0; 1·6, 2·5) and those residing in urban areas (Cambodia: 1·4; 1·1, 1·9; Myanmar: 1·7; 1·2, 2·4; Indonesia: 1·7; 1·5, 1·9). MDD deprivation was most severe among children from the poorest households in rural areas. The association between mother’s labour force participation and MDD was positive in all three countries but reached significance only in Indonesia (1·3; 1·1, 1·5).ConclusionsMDD deprivation among young children was significantly high in socio-economically disadvantaged families in all three study settings. MDD requirements are not being met for approximately half of young children in these three South-East Asian countries.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029712 ◽  
Author(s):  
Chandrashekhar T Sreeramareddy ◽  
Sam Harper

ObjectiveTo measure trends in socioeconomic inequalities tobacco use in Nepal.SettingAdults interviewed during house-to-house surveys.ParticipantsWomen (15–45 years) and men (15–49 years) surveyed in four Nepal Demographic and Health Surveys done in 2001, 2006, 2011 and 2016.Outcome measureCurrent tobacco use (in any form).ResultsThe prevalence of tobacco use for men declined from 66% in 2001 to 55% in 2016, and declined from 29% to 8.4% among women. Across both education and wealth quintiles for both men and women, the prevalence of tobacco use generally declines with increasing education or wealth. We found persistently larger absolute inequalities by education than by wealth among men. Among women we also found larger educational than wealth-related gradients, but both declined over time. For men, the Slope Index of Inequality (SII) for education was larger than for wealth (44% vs 26% in 2001) and changed very little over time. For women, the SII for both education and wealth were similar in magnitude to men, but decreased substantially between 2001 and 2016 (from 44% to 16% for education; from 37% to 16% for wealth). Women had a larger relative index of inequality than men for both education (6.5 vs 2.0 in 2001) and wealth (4.8 vs 1.5 in 2001), and relative inequality increased between 2001 and 2016 for women (from 6.5 to 16.0 for education; from 4.8 to 12.0 for wealth).ConclusionIncreasing relative inequalities indicates suboptimal reduction in tobacco use among the vulnerable groups suggesting that they should be targeted to improve tobacco control.


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